Diagnosed as such, erectile dysfunction is a disease of the 20th and 21st centuries, not because the disease was discovered only now, but because now its mechanisms are very well understood and several therapies have been developed to give results. Several major causes ultimately cause this erectile dysfunction, but the conclusion has been reached that there is practically no erectile dysfunction of a certain type, but they all have several triggering causes, in various proportions.
Classical approaches in the treatment of erectile dysfunction
ESWT technology or shock wave therapy?
How does the shock wave treatment work?
What are the steps of investigations and therapy?
The advantages of ESWT in the treatment of erectile dysfunction
Classical approaches in the treatment of erectile dysfunction
The classical treatment of erectile dysfunction has ancient roots because the condition also concerned the ancients. At that time, through empirical observations, it was demonstrated that certain plants have a stimulating effect. As such, various remedies appeared and were preserved, in one form or another, until the 70s.
Over time, both science and medical equipment and investigative equipment have evolved, which has led to addressing the causes of erectile dysfunction, and, consequently, the chapter on remedies has also developed.
Until the 80s, no extraordinary discovery was made in the field until the famous blue pill appeared, derived from a drug that was intended for another disease, namely for the treatment of pulmonary hypertension. It has been proven to be very effective in producing selective vasodilatation at the level of the vessels in the pelvic area implicitly of the penile vessels, and therefore of the arteries of the corpora cavernosa.
At the moment, we are in the fourth generation after drug treatment, with more and more selective substances that create fewer and fewer adverse effects.
Therefore, the medical treatment is considered classic and with reasonable effects that patients, in a proportion of over 50%, feel. Of course, there are also cases in which, with all the commercial success of these vasoactive substances, certain patients are refractory to this treatment. Their body does not react to this type of treatment.
There are also a series of medical procedures through which a new vasculature of the corpora cavernosa is artificially created by the transposition of nearby arterial vessels and the replacement of insufficient arterial flow. These interventions are still practiced today, but, from a financial point of view, it is quite an expensive option, compared to the classic medical treatment, and it involves an effort on the part of the doctor and the medical unit where it is performed. The learning curve is quite difficult in a procedure like this and there are few places in our country where this intervention can be used.
An alternative, also surgical, is the implantation of devices that create an artificial erection, such as a pneumatic pump. It is implanted at the level of the corpora cavernosa and has a pneumatic device attached through which the patient creates his erection when needed. Here the costs are considerable, the aesthetic effects are perhaps not among the happiest, hence probably the reluctance that many have for this implantation of pneumatic devices.
ESWT technology or shock wave therapy?
Shock wave therapy has recently benefited from the refinement, from a technological point of view, of the equipment that delivers the ultrasounds.
The procedure was identified as possible somewhere at the end of the 80s and started to be implemented in Europe and the USA only 5-6 years ago. The principle of shock wave therapy is successfully applied in the destruction of kidney stones, with the help of a device that produces, focuses, and directs a beam of shock waves toward a kidney stone that produces its destruction. It is about a purely energetic effect exerted on the tissues.
This energy can be adjusted so that it has a beneficial effect for the intended purpose.
The equipment with which this shock wave treatment is performed is of the latest generation, designed and produced by the company that patented this procedure, the best in the field of urology and interventions in this field.
The equipment consists of an ultrasound source, whose intensity and frequency can be adjusted by the user doctor. Ultrasounds are transmitted through a device similar to an ultrasound probe. If you were to visualize a procedure, you would not be able to tell if the patient is performing an ultrasound or an ESWT procedure, because the devices are quite similar.
This equipment treats not only erectile dysfunctions, but also musculoskeletal disorders, it has applications in the case of very troublesome diseases in both men and women – pelvic pain syndrome caused in men, especially by chronic prostate diseases, and in women by repeated urinary infections (cystitis), which often do not respond to classic drug, antibiotic or anti-inflammatory treatments.
How does the shock wave treatment work?
The therapy is applied in the case of erectile dysfunctions of vascular origin. Along with sexual stimulation, the reflex mechanisms produce vasodilatation at the level of the small arteries that vascularize the corpora cavernosa (which are like two elongated sponges, full of blood). When the blood flow increases, these sponges expand and fill even more with blood. This is the arterial mechanism through which the blood that irrigates the penis begins to come in increased quantity to this organ, causing its elongation and stiffening. But for this mechanism to be complete and sustainable, it is necessary that a second type of vessel, namely the veins, which depart from the penile bodies and drain the blood, in turn maintain the blood at the level of the organ, so that it does not occur the so-called venous leak because, otherwise, the blood once entered leaves via the venous path, in which case the erection either does not occur or has a very weak intensity.
Precisely for this reason, it is very important in diagnosing the cause, arterial or venous. If it is of arterial origin, then it will lend itself to this ultrasound treatment. The vast majority of erectile dysfunctions are arterial, while those of a venous nature, in the case of people whose veins do not contract enough to retain blood in the corpora cavernosa, will produce a decrease in the quality and intensity of the erection through the mechanism of venous leakage.
In over 50% of cases, erectile dysfunctions are arterial.
What are the steps of investigations and therapy?
Any patient with erectile dysfunction who decides to go to the Medicover clinic will be subjected to a fairly rigorous and detailed investigation protocol to determine whether or not they are suitable for its therapy.
It is about an anamnesis of the symptoms, a mandatory psychological consultation to detect the possible psychogenic component of this disease, and then a series of blood and urine tests to detect other possible factors besides the vascular ones.
An investigation of the state of the vascular system of the penis is also carried out using a Doppler vascular ultrasound, to practically quantify the available arterial flow and to find out whether his blood vessels at the penile level are still capable of sustaining an adequate erection.
After the elimination of any collateral causes or some main causes that do not belong to the vascular part, the patient will be included in the therapeutic protocol and the therapy will begin. This consists of 10 sessions of 30 minutes each applying these ultrasound beams through a device similar to an ultrasound probe. The ultrasound probe is applied to the penile body, at six different points, during the 30 minutes of therapy, in which the patient will be given all the privacy conditions (he is only in the presence of the doctor).
The therapy is not painful at all, the patient will only feel small tingling sensations on the skin.
At the first consultation, the patient will complete a questionnaire of 15 questions, through which the urologist will be aware of the degree and severity of erectile dysfunction, a questionnaire that practically quantifies the degree, and severity of erectile dysfunction in very severe, severe, moderate or mild.
At the end of the treatment sessions, the patient will complete the same questionnaire again to see what the improvement is after the treatment sessions and will perform a new Doppler ultrasound to see by what percentage his penile circulation has improved with the help of this therapy. The sessions are obligatory weekly and it is good for the patient not to interrupt them.
The treatment lasts two to two and a half months.
The advantages of ESWT in the treatment of erectile dysfunction
The effects of shock wave therapy, in the case of a good selection of patients, can exceed a year. In other words, an annual treatment may be sufficient. Often, the effects last for years.
Compared to current, classical, or surgical therapies, this new shock wave therapy represents an intermediate alternative that will be welcomed by the vast majority of those affected by this disease.
The treatment represents an acceptable compromise from a financial point of view, and from a psychological point of view, it avoids the traumas caused by a surgical intervention or the addiction that a medical treatment, psychologically speaking, creates over time.
We are not wrong if we say that in successful cases there is a significant improvement in the parameters of sexual and sustainable life. If this is repeated voluntarily by the patient, it may even involve curing the condition. The shock wave treatment, used in ESWT technology, has no side effects observed so far. The only variable is the way each patient perceives the tingling sensation during the intervention.
